By G. J. Ebrahim (auth.)
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Extra info for A Handbook of Tropical Paediatrics
8) Cerebral degenerative disease. (9) Congenital brain anomalies. (10) Space-occupying lesions. (11) Idiopathic epilepsy. Common Emergencies 55 EMERGENCY TREATMENT (1) Clear and maintain an airway. (2) Protect the tongue. (3) Administration of oxygen. 1 mg/kg. (5) Emergency specific therapy like parenteral glucose or calcium if indicated. ) Meningitis The older child will present with the classical picture of neck rigidity and other signs of meningeal irritation. These may be absent in the small infant and a full or bulging fontanelle may be the only positive sign.
However, the surface areas of different parts of the body in the child undergo changes with growth. The area of the head makes up a relatively larger proportion of the body in infants as compared with adults; on the other hand the extremities take up a smaller proportion of the body surface area. 2 2!. 2!. 2 8!. 2 3!. • 2!. 2 6!. 2 4 2!. 5!. 2 4!. 3 4!. 2 4!. 2 3!. 4 3!. 2 4!. 3!. 2 • • • • INITIAL PROCEDURES ON ADMISSION (1) Relieve pain by Inj. Morphine (1 mg for each 10 Ib body wt) or Inj. Peth ilorfan 25 mg.
If there is no clinical improvement, and urine has not been passed by the time Hartman's solution has been infused, dextrose in 115th saline should be given intravenously and the oral Darrow's solution should be continued. At this stage, blood should be taken for estimation of serum electrolytes and blood urea. Rapid rehydration leads to a high incidence of distu rbances of the central nervous system. This particularly applies when sodium levels are over 150 m. /I (hypernatraem ia) and to a lesser extent when hyponatraemia is present.
A Handbook of Tropical Paediatrics by G. J. Ebrahim (auth.)